Do people really change?

December 14, 2009 10:01 PM

I'm looking for figures on will-power. How many people who try to lose weight, quit smoking, kick an addiction, start exercising, etc. will be successful (particularly long term)? In other words, I'm looking for experimental or population studies on how often people are able to change their behavior in significant ways when they resolve to do so. Well supported anecdotal data about large groups ("vietnam vets were(n't) largely able to quit heroin on coming home") is only slightly less appreciated.
posted by elektrotechnicus to health & fitness (11 answers total)

Do you want citations? If not, a surgeon told me that fewer than 3% of obese people are able to lose more than 5kg and keep it off for more than five years.
posted by obiwanwasabi at 12:20 AM on December 15, 2009

If you are interested in why and how people change, I recommend the book Changing for Good. From the blurb: To uncover the secret to successful personal change, three acclaimed psychologists studied more than 1000 people who were able to positively and permanently alter their lives without psychotherapy. They discovered that change does not depend on luck or willpower. It is a self-help book, but it is based on research that is mentioned throughout the book and it is interesting even if you are not interested in changing anything at the moment.
posted by davar at 1:12 AM on December 15, 2009 [1 favorite]

Yes - people do really change. I've encountered the Transtheoretical Model of Behavior Change a few instances in the health field (which all your examples are from). As explained in that link, out of 100 people who are overweight/smokers/addicts/otherwise at-risk, the rule of thumb is:
- 40 of them are in the Precontemplation stage (no real plan for change within the foreseeable future)
- 40 of them are in the Contemplation stage (intending to change the behavior within the foreseeable future)
- 20 of them are in the Preparation stage (just like it sounds - getting ready to make the change - making the shopping list of low calorie foods, buying the patch, calling a help line, etc).

A lot of evidence out there points to this process (Precontemplation > Contemplation > Preparation > Action > Maintenance > Termination) as being one of the best models around for behavior change. As to how many people maintain that behavior change? That's another question.... how many people gain the weight back, start smoking again, relapse into addiction....
posted by pants at 4:55 AM on December 15, 2009

So, so far, other than the first comment, these answers are about something other than what you're asking for. The Stages of Change may be a good model for describing the change process, but it doesn't indicate what percentage of people are successful.

I don't have direct knowledge of any studies. There are many that provide part of the picture. If you google [population based weight loss studies] a bunch of results come up. Some are not really relevant (the top result) and some are partially relevant (this one about weight loss maintenance), but I'm sure you could refine the search somewhat. You could also go directly to pubmed. The maintenance study I linked indicates part of the problem, coming up with a good denominator for large population-based studies. You'll notice that the study is not of all people who tried to lose weight, just of those who did and managed to keep it off. Still, it provides some indications that people do have lasting change. In this vein, see also the National Weight Control Registry.

Anecdotally, however, and based on my practice as a clinical social worker, I will say that people do make lasting changes to fundamental aspects of their lives all the time. It is frequently a stop-and-start process, with re-dedication and several attempts necessary, but it does happen.
posted by OmieWise at 5:32 AM on December 15, 2009

I know it's usually considered snarky to link to a google search, but if you put 'willpower' and 'behaviour change' into Google Scholar, you get all sorts of interesting results. Perhaps some of them will help you?
posted by embrangled at 5:42 AM on December 15, 2009

There is also a recent literature in social psychology on the topic of self regulation. The link is to google scholar. The findings I have seen suggest that self regulation capacity varies between individuals, but that capacity can be increased through practiced use. The wikipedia article on self-control has some other information. It appears that Roy Baumeister is doing research in this area.
posted by bove at 6:35 AM on December 15, 2009

This paper looks like it might be the kind of thing you're after:

Weight-Loss Maintenance 1, 2 and 5 Years after Successful Completion of a Weight-Loss Programme MR Lowe, TVE Kral, K Miller Kovach. British Journal of Nutrition 2007; 28:1-6.

Weight-loss maintenance after successful completion of a commercial weight-loss program was assessed in 699 lifetime members of the Weight Watchers program. One, two and five years after successful completion of the program, 79.8%, 71.0% and 50% of participants maintained at least 5% of their weight loss. These findings provide further evidence that maintenance of weight loss for those who successfully lose weight is more beneficial than data from clinical populations suggest.

I found the link from here:
Weightwatchers research; as a WW member I'm aware that they take the whole behaviour change and maintenance thing really seriously, and do try to support peer reviewed research. I have not checked the original paper.
posted by handee at 7:17 AM on December 15, 2009

I get the rage really, really bad. Once while washing the dishes I found myself eying a big carving knife in a kind of "gee, this could some damange" way and freaked - by the time I finished calming myself down, I had drifted BACK to eying the knife in the same way - I could not even control my thoughts for the time it takes have the calming thoughts. In the past these periods last about 10 days - there's no way to "walk away" when I'm in those states, I just can't be around people at all and there's just no way I can carve out 10 days like that, not to mention how painful it was when I tried (I succeeded in quitting and it lasted a few years, then I fell off the wagon.)

I've done everything (including Wellbutron which did absolutely nothing)

A few months I saw a pulmonary who finally suggested something that I suspect will work and I have trying to build up the courage to try but haven't yet: Valium.
posted by victors at 7:56 AM on December 15, 2009

Losing weight is not necessarily a factor of will power. People have different metabolisms, illnesses, body types etc. and there is a large body of evidence that suggests that dieting actually causes additional weight gain over the long term. Any study that factors in will power would be highly suspect because that kind of thing is very difficult to isolate and measure.
posted by Kimberly at 7:59 AM on December 15, 2009

So, so far, other than the first comment, these answers are about something other than what you're asking for. The Stages of Change may be a good model for describing the change process, but it doesn't indicate what percentage of people are successful.
The question was "I'm looking for experimental or population studies on how often people are able to change their behavior in significant ways when they resolve to do so" The book I recommended mentions and is based on these studies.
posted by davar at 3:18 PM on December 15, 2009

how long does it take to establish a new habit? describes a study recently published in the European Journal of Social Psychology by Phillippa Lally and colleagues from University College London.
posted by LobsterMitten at 4:29 PM on December 15, 2009